Diminishing Returns

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Tuesday, August 8, 2017

Well...it's amazing but it has been more than 11 years now since I've had my roux en y surgery!

11 years ago I laid on an operating table in a different country USA - Michigan (I'm in Canada) and allowed some stranger to slice and dice my insides in hopes to be a healthier, smaller me. I was taking a huge chance - I had very few comorbidities - and was the healthiest fat person I knew. Would I be making a change for the better...or for worse?

My first year was an amazing ride! I waitedfor the horrible dumping and vomiting but in actuality, my post op life was, quite frankly, a breeze. Life was good. Reflections in mirrors gave me pleasure when I saw my smaller frame. I felt like I could conquer the world.

I was amazed to know that I conquered obesity! Life was normal and I was a normal sized person! I knew that no one could stop me. I would never ever go back. 148 lbs gone forever!!

Or were they?

Flash forward year 2 when the weight loss roller coaster found me again. Twenty pounds added to my frame felt like a hundred. I felt like I had failed. I wanted to smack my head against the wall. I was failing and my binge was back. I felt out of control and cried on the scale. How did obesity beat me again I wondered!? Time for therapy...

The next year, 5-10? pounds lost. I felt like I had the key to the "get the pounds off" mystery. I had control again. I was going to kick butt again. I would win.

Well you can repeat this whole gain-weight -and -lose weight cycle about a million times and then you'll know where I currently stand at year 11. I've gone as high as 31 lbs over my goal (just as recently as about four months ago) to about 5 over my highest (maybe 5 years ago?). Where I am at on the scale can vary at any given moment.....

One thing I know is that weight loss surgery has not solved my weight problem. It did not stop my food issues. I continue to battle the binge from time to time. I go through cycles of being perfectly on plan to imperfectly in self destruct mode. Eventually the scale keeps me grounded, kicks my butt and tells me to stop wasting my gift, to act like a bariatric patient again and to get back on program.

The key for me will be to always keep trying to renew my journey. I cannot afford to give up on myself. I have to keep trying to reinvent me. I must keep telling my truth and sharing my truth with others. I have to keep talking about the reality that life is not perfect post weight loss surgery, that the battle continues and that regain is real and not a sign of weakness. It's a sign of a battle that we are often still engaged with. It's a sign that we are human and that we are still dealing and coping.

Overall, weight loss surgery had been an amazing gift. I would not ever go back to a life of obesity. I have been blessed a thousand times over with the ability to be more mobile, to be medication free and to stay amazingly healthy. But it does not mean that life is easy or perfect and that weight is never an issue again.

So every day I get into my suit of armour and prepare to wage the war against my obesity. Most days I win. Some days I fall down, hard. But I always pull myself up, dust myself off and get back on track. There is no magic, no miracles. It's just hard work, discipline and choices made.

And it's quite frankly: One... day...at...a....time.

Happy 11 to me.:-)

Thanks for all of those who have supported me, befriended me and have provided support, kind words or friendship. I couldn't have handled the ups and downs without you all.

Please continue to SHARE YOUR TRUTH!!!

If you need any support in your journey and you feel like I could help you please feel free to add me. Just message me though so I know you aren't a spammer.

Sunday, November 2, 2014

Wow. I'm 8 years post op RNY already. Often I have people ask what life is like post op as a long timer and so this post will be a wrap up about my life, the good and bad, post op. I can finally say that I'm getting the "hang" of this whole maintenance thing finally. It's taken a while for me to get the hang of it. I didn't realize until I was around 2 years out that I was a binge eater and had an eating disorder. That's why now, I highly suggest that everyone preop examine the reasons they eat. It made life quite difficult past the first few years but now I feel like I am getting the hang of it finally. Let's just say that getting off the weight of surgery is EASY PEASY. There you go, I've said it. Yes it can be full of struggles - I remember being terrified of drinking and eating initially as if I was going to burst my pouch - but after you get past the first couple of months, it generally becomes much easier. But long term, it is a challenge to keep off the weight. Your metabolism becomes far more sluggish and it takes way more work to lose even a simple pound long term. Again, that's why I say so often to use your first year well and get to goal with no regrets!

At 8 years out, life is pretty good. Like everyone I have my great days and difficult days with food. I battle my FATHEAD every day trying to make healthy choices and to CHOOSE to exercise. It's a choice. Everything is a choice now. I either get off my butt or I watch the scale creep up. If I get off track with my eating, I see the scale creep up, and back I go, down to a back or basics eating plan. I still suck at moderation most days and if food is there, I will eat it. There's no magic to keeping it off. I know what works - lots of protein and exercise, very low carbs. Hard to sustain.

Medically no big issues other than the ones that I've known for years. Osteopenia of the spine that developed at year one (wrong form of calcium - we need citrate friends) but has stayed the same since. Anemia - always battling ferritin but haven't had it bottom out yet with hemoglobin. Always supplementing. Low vitamin D (Hello? I'm Canadian) and of course, Reactive Hypoglycemia (which I've managed well the last few years). That's it. They sound scary but other than watching my sugar intake and taking a few extra supplements, they really impact my life very little.

Positives - Life is GOOD. I fit in normal clothes. I range between a M-L in shirts, 9/10 or 11/12 in pants. I coach basketball and still walk like crazy. I did 5 half marathons and am calling a break until maybe Spring when I might consider taking up running again. Always undecided lol. I could end up doing bellydancing instead...who knows? Lol. I fit in backseats of cars, am not afraid of turnstiles or passing by groups of teenage boys, I do fit in one size fits all, I can shop in virtually any store, I can easily do all physical tasks and well, life is normal :)

The biggest change for me this year has been my attempt at resolving my body image issue. Although I know at times that I'm normal sized, I'm also at times very critical of my body. So well, it was time to pursue plastics. My tummy really has bothered me forever. It was time to fix this. So I finally decided to go for my tummy tuck. I was lucky enough to get OHIP to pay my panni portion and so out of pocket, it cost me $4080 to upgrade. I had a fleur de lis tummy tuck which includes a vertical incision in addition to the horizontal hip to hip cut. (This helps fix skin above the belly button as well). Dr. Matic in London removed four pounds of skin from my abdomen. I'm very pleased with results and hope that this well help me like my body a little more especially when it comes to summer time. It will also alleviate rashes and prevent hernias hopefully from happening in the future.

There's my life in a nutshell. Any questions? Just message me diminishingdawn @cogeco.ca (no spaces)

Saturday, August 16, 2014

Hypoglycemia refers to low blood glucose or blood sugar. While "dumping" is a result of too many sugars and makes you sick 20-30 minutes after eating, low blood sugar caused by reactive hypoglycemia can make you feel bad and it can be dangerous, since your brain requires a certain amount of glucose to function normally. Severe low blood glucose levels can cause passing out (loss of consciousness), seizures, car crashes, or other more serious outcomes. In people without diabetes, glucose levels are typically above 70 (3.8 Canadian) first thing in the morning, before eating and usually range from 70-120 (3.8 to 6.6) at other times of the day. (although it spikes shortly after eating).

The main organs in your body that are important for maintaining normal blood glucose levels are your pancreas and your liver. The pancreas makes and releases insulin into the blood stream. Normally, when you eat a meal, the pancreas makes insulin and the insulin helps to keep blood glucose levels from rising above normal. People who have high blood sugar, often having a problem with their pancreas.

The liver is also very important to help maintain blood glucose levels. The liver makes glucose, particularly between meals and overnight when you are not eating, so your vital organs can get the glucose they need to function normally. The liver ships out glucose to other body parts and is the distributor for your body.

There are two broad categories of hypoglycemia:

(1) Fasting hypoglycemia - refers to low blood glucoses in the morning, or when nofood has been eaten for many hours. You may wake up hungry, moody or feeling faint. Some people have to keep something by their bedside to consume before getting out of bed (but this is rare)

(2) Postprandial hypoglycemia (also called after meal or reactive hypoglycemia) - refers to low blood glucose levels within a few hours after eating. It is "reacting to food". The food is what sets off the chain of events for your blood sugar to go up and down like a roller coaster. It's "what you eat" that is usually the problem and so, you must take steps to eat differently with your RH in mind.

Postprandial hypoglycemia is also referred to as Reactive Hypoglycemia. It is a result of how your body is adept at processing sugar. If you eat something high in sugar or carbs, a lot of insulin is released in response to eating, and the insulin removes too much glucose from the blood. The insulin's job is to bring blood sugars back down but because it is getting all the sugar in the blood stream at once it is pumping out too much and bring blood sugar further down than expected. (When you had your pyloric valve sugar was slowly released and then insulin was also slowly released). Because the valve is gone, the sugar spikes you up fast and the insulin is released too fast. In some cases, this may be very severe i f the pancreas is making too much insulin.

Most often, reactive hypoglycemia shows up around the 1-2 year mark post gastric bypass...but can occur anytime really after the first 6 months, when the sugar response in gastric bypass patients becomes 20x as strong.

Symptoms:You may feel some or all of the following syraptoms within 1 to 4 hours after eating:Weakness
Racing or rapid heartbeat
NauseaExtreme hungerHeadaches, especially first thing in themorning (may indicate a low bloodglucose has occurred overnight)DizzinessSweatingDifficulty concentrating or thinkingNightmares or bizarre dreams - mayindicate a low blood glucose while youare sleeping Importantly, you may have nosymptoms, but others may notice thatyou are staring, not paying attention,seem less attentive, or are "not lookingquite right." Much like a brain fog.
Some also have a numb mouth or tongue.

Treating Lows:

It is critical to treat a low blood glucose quickly so that your brain has enough glucose tofimction normally and to prevent you from passing out. An important tool is a glucose meter or blood sugar metre used by diabetics. They can be costly but if you have the coverage, get one. It will make it much easier for you to figure RH out. Keeping a journal with blood sugar readings and foods, will help you greatly to learn what affects you and how it affects you. Most patients have a dropping point when their blood sugar starts to drop and will eventually become critically low. You need to know when that point is by testing at the 1 hour mark and every 10-15 minutes there after.

When your blood glucose is toolow, you need to eat food with sugar in it to bring your glucose level up quickly. You need to eat food with sugar, even though you may experiencing dumping syndrome (abdominalcramping, lightheadedness and diarrhea),

1. Stop what you are doing - sit down.2. Test your blood glucose, i f possible, to make sure that it is low.3. Eat 15 grams of sugar in the form of one of these "hypoglycemia treatments":a small juice box works great)- 3 tsp sugar-3 tsp jelly-small box of raisins-3 glucose tablets or 4 dextrose tablets >- 7-8 lifesavers (chew and swallow)-5-15 jellybeans (sugar content varies from 1-3 grams per bean - check label)

4. Retest your blood glucose after 15 minutes. Repeat treatment if glucose is under 80.5. After you treat the low glucose, eat a protein food (but not low fat ones) to preventthe low from returning - this is a critical step. You want protein to keep it sustained. Otherwise you will keep going low, high, low, high. Always carbs plus a protein:

6. Keep glucose tablets or glucose gel with you at all times. These are available at any pharmacy and do not melt or require refrigeration. Keep some in your pocket or purse, next to your bed, and in your car for emergency use. You don't want to take the time to search for a sugar food when you are having a low blood glucose! You may also find that 4 ounce juice boxes are convenient for the car. Honey packets work well too. Never ever drive when you may be feeling like you are having an issue. You could easily cause an accident and kill yourself or others. Stop and pull over if ever you feel like your blood sugar may be affected. Eat and test.

Being Proactive

It is really smarter to be proactive rather than reactive to lows. Every time you pass out from reactive hypoglcyemia it may lead to permanent brain damage. You must treat it seriously. Working to prevent a low is always better than to reactive to contant highs and lows. Plus, being reactive rather than proactive can also lead to cycles of eating when you are not supposed to and can easily lead to regain!

1. Modify your diet. Chances are that it was a food that caused the problem to begin with. What did you eat? Learn what your marker time is for your blood sugar to dip. For instance, for me it is at the 1 hour, 15 minute mark. If I dip, I need to know that is when I need to eat preventatively. But again, if you can avoid a low by changing what you eat that's always better.

• At meals, eat controlled portions of low glycemic carbs. Add fat to your eating. Many protein foods have fat in them and the fat in the protein food also slows the digestion of the carbohydrate. This will lead to less of a "spike" in blood glucose after you eat and result in less insulin secretion (which is what you are trying to avoid).• . Carbohydrates that are high in fiber are typically slowly digested. Read labels and look for whole grains rather than "enriched" flour, which has much of the fiber removed.• Avoid high glycemic carbohydrate foods • Avoid eating only carbohydrate at a meal or snack Always eat a carb with a protein. Always!• Avoid eating carbohydrate in excess amounts (stick to 25 garms of carbs per meal. Remember, it's not just sugar --but it's also carbs because carbs turn into sugar!).

Many reactive hypoglycemia patients have had excellent results with a paleo or primal diet. You can google the terms for a shopping list. Mostly, you need to cut out the carbs and focus on proteins. If you bake, use alternative flours (coconut, almond etc) and add fats. These types of baked goods will affect you far less than goodies made with traditional white flour and sugar. Read and learn. marksdailyapple.com is a good source for information!

Sunday, August 3, 2014

I know that when reading many blogs for RNY, people get upset because the journey ends at a year out or two, and many don't write posts on how they are doing after many years. For that reason, I like to update my blog so that people can get an idea of what life is like many years post op RNY. Now, I've always been a bit abnormal in some ways - easy peasy recovery, very few issues....but we all know that the experience of surgery is different for everyone. So here, I'll update you about how things are and tell you about anything new I've learned or experienced:

The Good:

-Life is pretty typical - I continue to be very active and to walk 5 to 10 miles a day is not unheard of for me. I am active and busy and still enjoying life without having to worry about turnstiles, getting in the backseat of a two door car, that one size won't fit all, and all the typical stuff of morbid obesity. I can say that I've sideswiped many possible health issues and I can confidently say that I know that I won't ever go back to being morbidly obese. While I definitely have my challenges most days with my eating, I am pretty confident that I understand how to manage my weight now. Hopefully there won't be any obstacles with this and I can keep doing what I'm doing.

-My deficiencies seem to be okay. Not much different than before. Not improving much, but not getting terribly bad either. I'm still osteopenic (since year 1) but it is the same - no worse/no better and I'm okay with that. Iron still sucks but not enough that I need infusions. Still vitamin d deficient (aren't most Canadians? yes!). Other than that I'm holding my own and that's a good thing!

-While I go up and down on the scale (I can be as close as 5 lbs to my goal weight or as high as 20 lbs over - and then I get my act together and work on it) I'm staying fairly the same. That's a good thing even though I can really beat myself up over it.

-The clothes in my closet are one of two sizes. I've bumped up one size from my lowest so I guess in the scheme of things that isn't too bad. I am still working on getting down.

The Bad:

-I beat myself up over regain constantly.

-There are days that my eating is out of control. I am still a slave to sugar. Some days sugar wins, and some days I win. It sucks.

-I still want to get back to goal and it's a bugger to control the eating most days.

The Ugly:

-The skin. Hoping to get a tummy tuck come Fall/Winter. I have OHIP approval for a panni so I'm just having to save money for the upgrade.

-Some days my reactive hypoglycemia kicks my butt but I'm far better at managing it now. I had two pass out incidents but for the last few years manage it fairly well without problems. I understand it much better now.

Really there's not much in the way of ugly to be honest. No big complications or problems. Have never been in the hospital overnight since my surgery. No horror stories at all.

Wednesday, March 12, 2014

I see these posts all the time on just about every board that I read. A sense of panic that someone has not lost all their excess weight in a manner of minutes, hours and days.

*sigh*. Big giant sigh!

You need to wrap your head around realistic expectations. You did not gain 50, 100 or 150 lbs over night. You will NOT lose it over night. This takes time. This takes the right ingredients.

WLS is like baking a cake.

When you decide to bake a cake, most of us just can't go into any cupboard, grab ingredients and within a matter of minutes, have a cake baked, done and frosted. Weight loss (even with wls) takes time, balance and the RIGHT ingredients.

Before we decide to bake a cake, most of us have to read and find the right recipe. We might have to research a bit before something seems to be "just right" for us to make. We have to find a recipe for success. It may take lots of consultation, lots of reading, talking to experts until we find the right recipe for the occasion.

Then we have to go shopping for all the right ingredients. We have to make sure that we have all the right food ingredients as well as pots, pans and utensils. Measuring cups guarantee success. Without that careful measurement, our cake may not rise or may be a total disaster. Planning is key.

We might even take a "dry run" and practice that recipe before we actually make it for that special occasion. We know that skills are not innate, they are practiced. We might even find that the recipe needs a "little something" so we may consult others for advise. We may talk to other baking experts about that one missing ingredient. We may even tweak the recipe accordingly and find that our recipe is better than the original!

The day of the big event, we are prepared in all ways for the task ahead of us. We know that a good cake will take some time. We give ourselves plenty of time so that we can slow down and be exact with our measurements. We know that being rushed won't help make the cake better. It's about exact measurement and precision. We don't just throw together ingredients. That doesn't work. It takes time.

Once we carefully measure, mix and pour, we wait. We wait some more. We wait some more.

Even the best cakes don't come out of the oven in 60 seconds.

That time waiting is precious. It's exciting anticipation of what is to come. We know that it will be totally worth the wait. We know that the cake is worth waiting for. Even though we have to wait, we don't question that we will have a cake when the process done. We know that we've prepared the cake the way we need to.

We know that we are set up for success. We added all the right ingredients. We know that we have had good practice. We know that we have all the ingredients and all the right tools. We know that in 40 minutes our cake will be done and it will be a success because we've set it up that way.

And even, when you take your cake out of the oven, there is more time to wait before you can frost it. Patience is required. It will take time, more time and even more.

Stop thinking that your cake will be baked in 3 minutes. If you've done all the planning, followed the rules and set yourself up for success, you have nothing to worry about. Everything worth waiting for takes time.

Saturday, January 11, 2014

I put this on my webpage7 years ago and it has made its way through cyberspace on many, many blogs.

REALISTIC EXPECTATIONS!

While you will lose weight in the first few months after bariatic surgery,
you reach your maximum weight loss in 12 to 18 months. Here is what
you can expect to lose post op!

For
patients weighing 200 to 250 lbs.
10 lbs. in first 10 days
15 to 25 lbs. in 6 weeks
25 to 35 lbs. in 3 months
35 to 45 lbs. in 6 months
60 lbs. or more in 1 year
70 lbs. or more in 18 months

For
patients weighing 250 to 300 lbs.
10 to 12 lbs. in first 10 days
15 to 25 lbs. in 6 weeks
25 to 35 lbs. in 3 months
45 to 60 lbs. in 6 months
80 lbs. or more in 1 year
90 lbs. or more in 18 month

For
patients weighing 300 to 400 lbs.
10 to 30 lbs. in first 10 days
25 to 45 lbs. in 6 weeks
35 to 55 lbs. in 3 months
50 to 80 lbs. in 6 months
100 lbs. or more in 1 year
120 lbs. or more in 18 monthsee

(The error above is often copied on pages lol). For
patients weighing 400 to 500 lbs.
10 to 30 lbs. in first 10 days
25 to 45 lbs. in 6 weeks
35 to 60 lbs. in 3 months
50 to 90 lbs. in 6 months
120 lbs. or more in 1 year
150 lbs. or more in 18 months

Sunday, December 1, 2013

There's not a lot that irks me in the online world. I spend much of my free time lurking on OH and reading and admining various wls specific groups on Facebook. I understand the differences between newbies and oldtimers like myself and the different ways that we see the world. There's generally not that bothers me, but there is one phrase that bothers me and I'll explain why today.

When people post their weight loss, I often see the phrase "100 lbs gone forever". This is the phrase that bothers me. It might seem strange but I feel that when we engage in talk of forever that we are taking something for granted. We are taking our weight loss for granted. Early out in the honeymoon period, we get this sense of invincibility because life is smooth, temptations are low and hunger is low. We think that life is going to be that way forever.

Tis not so for most of us.

I've gained back 10 lbs. 15 lbs, 20 lbs, 25 lbs. I know that it is not necessarily FOREVER.

This is DAMN hard work. It is hard to keep our mind always on what we should be doing. It is difficult to keep our demons away. It is hard to stop eating emotionally when you've done so for 10, 20 or 30 years. It's not all rainbows and unicorns.

Eventually you realize that this is WORK. For the rest of your life nonetheless.

And it is easy to slip into old habits. Very easy.

It's very easy to become unfocused, to be unaccountable and to avoid the scale.

This is FOREVER, not just for one year.

And hunger returns. And life goes on. The compliments stop coming. Motivation wanes.

I want to scream and shake people and say "Don't say FOREVER. You don't know how EASY it is to do!!".

Don't take anything for granted. Don't think that you can just do "moderation" when you sucked so badly before at it. KEEP THE TRIGGERS OUT.

I want to say that dessert shouldn't even be in your vocabulary at 4 weeks out. You shouldn't be having a cookie! If you think it's a challenge now, wait until year three or four or eight or twelve. Keep it out.

When you are a long timer, you see so many people struggling early. You see people that are failing. You want to reach out and say "Don't go there!!!!". Stay the course. Don't give in yet!! Get to goal. You want people to succeed. You want people to do better than you and not to struggle with food demons. It's hard. You know what it's like when after a year, you started having goodies again. You see people digging into Pandora's box far, far too early.

But then you shut up because you know that newbies won't understand. They'll think that you are just being mean and not letting them enjoy a "small bite" of everything because they think that their small pouch will keep them in line forever. *sigh*.

It's a different mindset.

At 7.5 years out, and around 15 lbs up at the moment over my goal, I'm frustrated. I'm angry. I'm pissed that I have to get back to all the incredible hard work it takes to lose the weight now at this juncture. It's not the same as the first year. It's a huge ass kicking to even lose a lb or two now. It blows the mind how much effort it takes to lose when a gain can be acquired from a bad weekend.

Feeling a little down...but I've done it so many times before - pick myself up, dust myself off and begin again. It gets a little tiring though to be honest. I just want to know how to do this whole damn moderation thing successfully after many years of yo yo-ing up and down the same 5, 10, 15 etc pounds.